LOST and FOUND:Fremdkörper im Becken

Andreas Salat

ISDS-Tagung 13.06.2016 Brac

Disclaimer

YoutubeTop 10 Craziest Foreign Objects Found

Stuck In A Rectum

Liveleak.comEel removed from new Zealand Mans

rectum

Systematik

Autoerotisch(Dildos, Zuckerdosen, Maiskolben, Nektarine,…)

Bodypacker(Kokain in Kondomen)

iatrogen.(Schrauben, SNM-Drähte, Knochen,…)

Systematik

Autoerotisch(Dildos, Zuckerdosen, Maiskolben, Nektarine,…)

Bodypacker(Kokain in Kondomen)

iatrogen.(Schrauben, SNM-Drähte, Knochen,…)

Systematik

Autoerotisch(Dildos, Zuckerdosen, Maiskolben, Nektarine,…)

Bodypacker(Kokain in Kondomen)

iatrogen.(Schrauben, SNM-Drähte, Knochen,…)

Systematik

Autoerotisch(Dildos, Zuckerdosen, Maiskolben, Nektarine,…)

Bodypacker(Kokain in Kondomen)

iatrogen.(Schrauben, SNM-Drähte, Knochen,…)

Systematik

Autoerotisch(Dildos, Zuckerdosen, Maiskolben, Nektarine,…)

Bodypacker(Kokain in Kondomen)

iatrogen.(Schrauben, SNM-Drähte, Knochen,…)

Stift A. personal communication

saisonale Schwankungen

Pathak R et al N Am J Med Sci. 2016 Apr;8(4):191-3

USANationwide

n=3359 (3 Jahre)

Further studies would be required to verify whether our findings of a higher

incidence in the fall season are reflective of acute changes in the length of the days, climate, sleep-wake cycle, or decreased sexual intercourse at this

time of the year.

Mann vs. Frau

Odagiri H et al. Digestion. 2015;92(3):165-70

Japan, nationwide, n=666 (6 Jahre)Männer 81,1%

In-hospital Sterblichkeit 1,2%

Compared with males, females had a significantly higher proportion of in-hospital death (0.4 vs. 4.8%, p = 0.001),

perforation and peritonitis (5.2 vs. 12.8%, p = 0.004), and sepsis (1.1 vs. 4.0%, p = 0.04).

Anatomische Überlegungen

Anatomische Überlegungen

Diagnostik - Abdomen leer

Diagnostik - CT

Diagnostik - CT

Diagnostik – 3D-CT

Extraktion

MacDonald AP. Practitioner 1961; 186: 370–371

Extraktion

Lim KJ et al. Intest Res. 2015 Oct; 13(4): 355–359.

Extraktion

Obinwa O et al. Int J Surg Case Rep. 2015;15:96-8

Saugglocke

Johnson SO et al. Dis Colon Rectum 1996;39(8):935-7

Use of the delivery vacuum extractor provided a safe, cost-effective method of glass foreign body removal by the transanal route. Literature review found no other reports of rectal foreign body removal by this method.

Laparotomie

In a series of 48 patients reported successful extraction in the emergency department in 31/48 (63%) patients and operating room extraction in 18/48 (37%) patients, 12 cases were simply extracted under anaesthesia, five patients required primary repair and diverting colostomy 5/48 (10,4%) for rectal perforation and one required primary repair of an external anal sphincter laceration.

Andere Serie: 7/30 (23%)

Chronischer Abszeß

Stift A. personal communication

TAKE HOME

„Alles gibt`s“

Selten Iatrogen, meist autoerotischPerforation ausschließen

Schamgefühl achtenChronischer Abszeß nach

Voreingriffen